Provider Demographics
NPI:1811346992
Name:BENJAMIN, MARIA ELENA MOORE (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA ELENA
Middle Name:MOORE
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA ELENA
Other - Middle Name:MOORE
Other - Last Name:KERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:555 PRESIDENT ST UNIT 922
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-6306
Mailing Address - Country:US
Mailing Address - Phone:860-208-5123
Mailing Address - Fax:
Practice Address - Street 1:185 S ORANGE AVE RM G-506
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2757
Practice Address - Country:US
Practice Address - Phone:973-972-5045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA120417002086X0206X
MDD93997208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology